Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Chronic obstructive pulmonary disease (COPD) is preventable and treatable. If you have COPD, you may feel short of breath and find it hard to breathe because less air flows into and out of your lungs. Your breathing tubes can swell and produce excess mucus. COPD can cause other changes in your lungs that cannot be reversed. In severe cases, you may need oxygen therapy. COPD can lead to respiratory failure.
There are 2 main types of COPD:
Some people with COPD also have asthma. Some people will have a mix of both types of COPD and asthma. COPD can be prevented and treated, but asthma is not preventable.
Smoking is a major cause of COPD. We do not fully understand what causes COPD. While many factors may increase your risk of developing COPD, about a fifth of people with the condition have no known risk factors.
Common risk factors include:
Here are steps to take to reduce your risk of COPD:
The symptoms of COPD vary. Some people may have no symptoms, and we may find COPD during a routine chest X-ray or with other tests. Others may not recognize symptoms because they do not exercise enough to cause shortness of breath.
Common symptoms of COPD include:
The diagnosis of COPD may be difficult to make since many people have no obvious symptoms. For those who are diagnosed, the symptoms are:
Physical examination does not usually show any abnormalities until COPD is fairly advanced. At that point, the findings on examination are:
For an accurate diagnosis, we may recommend lung function testing, or spirometry. Spirometry is the most accurate way to diagnose COPD because there are other health conditions that can mimic the symptoms of this condition.
Spirometry checks your lung function. It looks at how air flows into and out of your lungs, and how oxygen goes back and forth between your lungs and your blood.
Here it is how it is done:
Your response to this medication will help us determine if you have asthma or COPD.
The information from this test is much better than a chest X-ray for finding out if you have asthma or COPD. It is also more accurate than using a peak flow meter or listening for wheezing to check your lung function. The results of this test will tell us whether medication will be helpful in treating your condition. It should not take more than an hour of your time.
Before a chest X-ray, your level of oxygen saturation is measured at rest or with exertion depending on your situation. it is used to determine if you need home oxygen therapy.
Chest X-ray may be helpful in the diagnosis of moderate to severe COPD.
The treatment of COPD must be tailored to the individual. There are treatments for chronic COPD and treatments for flare-ups of COPD. The goals are to decrease symptoms and to improve your ability to enjoy your life. We specifically want to decrease the possibility of flare-ups and increase your ability to exercise.
Commonly used medications include:
If you are at risk for heart disease, we may also recommend that you take a statin drug (medication to reduce cholesterol).
Vaccinations are important to prevent flare of COPD:
Oxygen. Prescribed for patients with severe COPD who have low oxygen blood levels. It can improve lifespan and quality of life.
Surgery. People with emphysema, mainly in the upper part of the lungs, who have a low ability to exercise, may benefit from lung volume reduction surgery.
Lung transplant. This is reserved for people with COPD with severe symptoms of emphysema due to an inherited disorder called alpha-1 antitrypsin deficiency.
These episodes are caused most often by exposure to viruses and bacteria. Less often they may be due to an environmental pollutant, and in a few cases, no cause is found. Other medical conditions such as heart problems or blood clots in the lungs called pulmonary emboli may worsen with COPD.
An Emergency Department visit is sometimes needed during a flare-up. The treatment may include medications and oxygen.
Quitting smoking is an important part of your treatment. We can help you find resources that will work for you.
It is important for you to stay active in order to maintain and increase your lung function. Comprehensive pulmonary rehabilitation, which includes exercise training, may be helpful to improve ability to exercise, decrease shortness of breath, and increase self-care.
Good nutrition is important. Supplements or appetite stimulants may be needed to increase protein and calorie intake.
If you are having significant trouble breathing, act quickly. Call 911 emergency services before you call anyone else.
If you have COPD and it is hard for you to breathe, please call our Appointment and Advice line. Trained, experienced nurses are available 24 hours a day, 7 days a week. They can give you immediate advice about what to do. If you want to connect with me directly, they can send me a message or book an appointment with me.
We urge you to call under these circumstances:
Based on your symptoms, medical history, and any tests I may order, I will confirm your diagnosis. We will discuss potential lifestyle changes, therapies, and treatment options that are right for you.
If you have difficulty managing your COPD, I may recommend that you work closely with a COPD Care Manager. If you have COPD and you are working with a Care Manager, you may call him or her directly. If you are interested in a referral to this program, please contact me.
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
My goal is to provide high quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.